Efficacy of tricyclic antidepressants in irritable bowel syndrome: A meta-analysis

Table 1 Jadad quality score of randomized controlled trials included in the meta-analysis

Study	Factors and Jadad score
	Randomization	Blinding	Withdrawals and dropouts	Total Jadad score
Vahedi et al[16], 2008	1	1	1	3
Talley et al[17], 2008	2	2	0	4
Morgan et al[18], 2005	1	1	1	3
Rajagopalan et al[19], 1998	1	2	0	3
Vij et al[20], 1991	1	1	1	3
Greenbaum et al[21], 1987	1	1	1	3
Tripathi et al[22],1983	1	1	0	2

Table 2 Characteristics of papers included in the meta-analysis

Study	Mean age	Sex		IBS subtype	Type of TCA	Daily dosage	Duration of treatment/follow up (wk)
		Female	Male
Vahedi et al[16], 2008	36	21	29	D-IBS	Amitriptyline	10 mg	8
Talley et al[17], 2008	ND	21	13	D-IBS, C-IBS, Alt-IBS	Imipramine	2 wk: 25 mg; Thereafter to the end: 50 mg	12
Morgan et al[18], 2005	39	22	0	D-IBS, C-IBS, Alt-IBS	Amitriptyline	First week: 25 mg; Thereafter to the end: 50 mg	4
Rajagopalan et al[19], 1998	34.8	11	11	ND	Amitriptyline	First week: 25 mg; 2nd week: 50 mg; Thereafter to the end: 75 mg	12
Vij et al[20], 1991	32.5	14	36	D-IBS, C-IBS, Alt-IBS	Doxepin	75 mg	6
Greenbaum et al[21], 1987	45.2	18	11	D-IBS, C-IBS	Desipramine	First week: 50 mg; 2nd week: 100 mg; Thereafter to the end: 150 mg	6
Tripathi et al[22], 1983	37	ND	ND	ND	Trimipramine	30 mg	5

IBS: Irritable bowel syndrome; D: Diarrhoea predominant; Alt: Alternating; C: Constipation predominant; TCA: Tricyclic antidepressant.

Table 3 Response to treatment

Study	Definition of response	Response		Change in abdominal pain score (No. of patients)
		TCA	Placebo	TCA	Placebo
Vahedi et al[16], 2008	Complete loss of symptoms (total score= 0) at the end of the study or at least two scores with a decrease in the number of symptoms	17/25	10/25	-	-
Talley et al[17], 2008	Adequate relief of IBS symptoms over 50% of the weeks	10/18	9/16	-45.3 ± 26.3 (18)	-7.4 ± 46.9 (16)
Morgan et al[18], 2005	Improvement of IBS symptoms determined by patients	13/22	5/22	-	-
Rajagopalan et al[19], 1998	Global well-being: patients were asked to estimate at the post-treatment interview how much better or worse they were on the whole (in percentage) as compared to the pretrial period	7/11	3/11	-	-
Vij et al[20], 1991	Improvement of 50% or above in IBS symptoms	11/21	5/23	-	-
Greenbaum et al[21], 1987	Global assessment of improvement	15/28	5/28	-58.96 ± 19.37 (28)	-13.93 ± 17.76 (28)
Tripathi et al[22], 1983	Improvement of 50% or above in IBS symptoms	7/25	4/25	-	-